SP22 689 Weekly Wall 5 by Sara Police https://padlet.com/sarapolice/gv78w878l5hfb2iy Identify a research paper relevant to this week’s topic. Post the citation along with answers to these questions in a padlet post to The Weekly Wall. Your post should be at least 150 words (not counting the citation). Respond to a classmate’s padlet with a question, comment or link to a related study. Address the following questions: 1) Why is this study important 2) Identify one key finding of this study and describe how it relates to nutritional sciences. 3) What are the clinical implications of this study? en-us 2022-01-04 13:14:16 UTC 2022-03-08 20:29:51 UTC hello@padlet.com Katelyn Spain: Physical and mental health related quality of life changes among insurer subgroups following bariatric surgery https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044179681 Over the past few decades, obesity has increased in the world and over the past few years bariatric surgery has become more known, especially through the media. This study is important because it shows the more long-term effects bariatric surgery can have on patients that were previously diagnosed as morbidly obese. It was found that patients receiving the surgery, after five years, their physical health-related quality of life had significantly improved, while their mental health-related quality of life did not improve significantly. There were a lot of physical-health related factors such as diabetes, hypertension, dyslipidemia, sleep apnea, ischemic heart disease, congestive heart failure, history of stroke, pulmonary hypertension, asthma, history of deep vein thrombosis or pulmonary embolism, and venous edema with ulcerations that contributed to the overall score of physical health improvement. These symptoms and comorbidities were significantly improved with the surgery according to patients. However, one key finding of the study found that the mental health of these patients was similar to those of the general US population and to those patients who had not had bariatric surgery. This study also separated the patients into two groups: those who had the surgery performed under Medicaid insurance and those with private medical insurance. I thought this was interesting and they found no significant differences between these groups. As for the clinical implications from this study, it was proven that bariatric surgery will have positive effects on an obese patient’s physical health and that patients who are morbidly obese should seek this treatment to improve their physical well-being and lifespan. The article also discussed how bariatric surgeries should be more available to patients.
Takemoto, E., Wolfe, B. M., Nagel, C. L., & Boone-Heinonen, J. (2020). Physical and Mental Health-Related Quality of Life Changes Among Insurer Subgroups Following Bariatric Surgery. Obesity (Silver Spring, Md.), 28(3), 669–675. https://doi.org/10.1002/oby.22718]]> 2022-02-13 02:20:02 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044179681 Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation rwpr222 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044545458 The research paper selected for this week is titled: “Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation”

This research paper is a 2020 review study from Department of Pediatrics and Institute for Health Policy Studies, University of California, San Francisco, CA 94143, USA and Department of Research, Touro University-California, Vallejo, CA 94592, USA. This single authored encyclopedic review article is by Robert H. Lustig, M.D., M.S.L., Professor emeritus of Pediatrics, Division of Endocrinology at the University of California, San Francisco (UCSF). (This article belongs to the Special Issue The Clinical Utility of Food Addiction and Eating Addiction published by Nutrients.)

This study is important because the pandemic of non-communicable diseases (NCDs; type 2 diabetes, cardiovascular disease, fatty liver disease, hypertension, heart disease, stroke, cancer, and dementia), has its origins in our Western ultraprocessed food diet. NCDs account for 72% of the deaths and 75% of health care dollars. Obesity is a “marker” for the pathophysiology of NCDs, but not a primary cause—because a percentage of normal weight people get NCDs as well, while a percentage of people with obesity are metabolically healthy.

The key findings from this study are that added sugar, and by proxy the ultraprocessed food category, is both toxic and addictive, sugar reduction promotes health, is achievable, and is necessary, and added sugar ultraprocessed foods meets the four criteria set by the public health community as necessary and sufficient for regulation—abuse, toxicity, ubiquity, and externalities. While public educational efforts are necessary to warn about the hazards of chronic excessive sugar consumption, they will not be sufficient, as has been seen for every other hedonic substance.

Clinical implication from of this study is that the health care community needs to support policies that target availability, affordability, or acceptability of added sugar ultraprocessed foods. For example, ban sales of sugar-sweetened beverages in the workplace, tax the sales of added sugar products, and create a stigma on the consumptions of added sugar utraprocessed “foods.” 1

Lustig RH. Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation. Nutrients. 2020; 12(11):3401. https://doi.org/10.3390/nu12113401

Richard Proudfoot

 

]]> 2022-02-13 13:32:02 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044545458 Weight Discrimination and Risk of Mortality https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044622795 Weight Discrimination and Risk of Mortality (nih.gov)

This study analyzed the health implications that can result or be exacerbated due to weight associated discrimination in health care settings. It was found that of the participants studied, “weight discrimination was associated with nearly 60% increased mortality risk for patients in HRS (renal disease) and MIDUS, that was not accounted for by a common physical and psychological risk factors.” Participants who had experienced healthcare associated weight discrimination were described as having increased food consumption, potential blood pressure increases, and stress as a result. The clinical implications of this study are awareness for health care providers, and patients. This discrimination affects people’s health, willingness to go receive future healthcare, and is not acceptable way of treating anyone. This is another example of potential discrimination that can occur which needs to be addressed in training to alert for any bias (unconscious or conscious). This relates to nutritional science because it can affect patient participation in nutrition counseling, adherence, resistance, or consideration as a provider.

Sutin, Angelina R et al. “Weight Discrimination and Risk of Mortality.” Psychological science vol. 26,11 (2015): 1803-11. doi:10.1177/0956797615601103

Emalee Haynes

]]> 2022-02-13 15:04:57 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044622795 Semaglutide an Alternative Treatment for Obesity- Ashley Wahlman anwa238 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044902750 This is an important study because it offers obese patients an alternative route to surgery. I believe many people would prefer a solution that first doesn't require surgery and that is exactly what this new medication known as semaglutide provides. This drug is a glucagon like 1 peptide typically used to treat type ll diabetic patients. In a study completed, patients were given semaglutide weekly for 68 weeks along with lifestyle changes such as a low caloric diet. At the end of the 68 weeks 1/3 of these patients had experienced weight loss 20% from their baseline weight, which is comparable to having a post sleeve gastrectomy which yields 20-30% weight loss after 1-3 years.  This is great because individuals who have reached a specific weight and would qualify for bariatric surgery would have an alternative for going under the knife. However, it would be important to stress to patients still the importance of a healthy diet because no matter if you go under the knife or you take a medication the only way you will achieve the best results is through diet. The clinical implications is that people wouldn't have to take unnecessary risk if they are obese they now have another option to explore before completely having to undergo bariatric surgery which comes along with complications. For example, in some cases with bariatric surgery patients may develop an eating disorder, which may lead to anorexia/bulimia. I think this is a great alternative that minimizes some of those risks and provides the patient with another option before completely going under the knife.

Works Cited
Bham, A., & Ditta, M. A. (2021). Semaglutide for the treatment of obesity – a review. Middle East Journal of Family Medicine, 19(9), 61–64. https://doi-org.ezproxy.uky.edu/10.5742/MEWFM.2021.94116]]> 2022-02-13 19:55:58 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2044902750 Microbial Medicine: Prebiotic and Probiotic Functional Foods to Target Obesity and Metabolic Syndrome - Esraa Zamzami ezamzamiez https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2046979085 For this week’s weekly wall, the paper I chose talks about the relationship between gut microbiota and obesity. Scientists realized the significant difference in the composition and diversity of obese individuals’ gut microbiome related to other lean individuals. Obese individuals have a condition called dysbiosis, which means that the composition and diversity of the healthy microbiota have been disturbed, leading to an unhealthy environment in the gut.
This study is important because obesity is now considered a global epidemic and targeting the microbiome for a potential therapy is less invasive and demanding. One of the main key findings in this paper is that the short-chain fatty acids produced by the gut microbiota can induce modulation of appetite and metabolism in individuals. This can happen through many pathways, for example, stimulating the secretion of glucagon-like peptide 1 that promotes intestinal gluconeogenesis, enhances insulin sensitivity and reduces appetite. Additionally, SCFAs enhance the production of peptide YY and leptin that reduce energy intake and increase satiety levels. This directly relates to nutritional sciences because it affects the appetite and metabolic pathways that may lead to weight reduction. The clinical implication of this study is that recommendations to increase probiotics and prebiotics consumption to enhance the gut microbiome could be helpful.


Green, M., Arora, K., & Prakash, S. (2020). Microbial Medicine: Prebiotic and Probiotic Functional Foods to Target Obesity and Metabolic Syndrome. International journal of molecular sciences, 21(8), 2890. https://doi.org/10.3390/ijms21082890


]]> 2022-02-14 18:49:36 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2046979085 Vitamin D Deficiency: Consequence of Obesity? -Cole Cincinelli ccci222 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2047516695 “Vitamin D (VD) is essential for the maintenance of bone tissue, as well as for homeostasis of the minerals calcium and phosphorus. Its receptors have been found all over the human body indicating multiple functions.”[1]  Serum vitamin D is lower in obese people as it is also distributed throughout fat, muscle and liver. With the increased fat mass in obese individuals, increased levels of vitamin D are store there leaving less in the serum. Although its crucial role in bone tissue maintenance, obese adults do not have lower bone mineral density.[2] Further research is in the process of looking into the full extent of lower serum vitamin D in obese patients and its affect. Bone loss has been an observed effect in patients undergoing bariatric surgery. This could possibly be a result of the low levels of serum vitamin D combined with the malabsorption of nutrients from bariatric surgery. Important clinical implications would be to ensure vitamin D sufficiency in obese patients and especially bariatric patients to help attenuate bone loss. 

[1] Vranić, L., Mikolašević, I., & Milić, S. (2019). Vitamin D Deficiency: Consequence or Cause of Obesity?. Medicina (Kaunas, Lithuania), 55(9), 541. https://doi.org/10.3390/medicina55090541

[2] Walsh, J. S., Bowles, S., & Evans, A. L. (2017). Vitamin D in obesity. Current opinion in endocrinology, diabetes, and obesity, 24(6), 389–394. https://doi.org/10.1097/MED.0000000000000371

]]> 2022-02-15 01:23:34 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2047516695 Ivana Djuricic--Gut microbiome and obesity https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2047581731 Delzenne, & Cani, P. D. (2011). Interaction between obesity and the gut microbiota: relevance in nutrition. Annual Review of Nutrition, 31(1), 15–31. https://doi.org/10.1146/annurev-nutr-072610-145146
 
This paper points out the importance of the gut microbiome when it comes to obesity and how a high fat diet can change your microbiome to make you more susceptible to metabolic diseases. Short chain fatty acids, indirect nutrients produced by gut microbiota, have roles in regulating immunity, energy metabolism and adipose tissue expansion. Changes in gut microbiota are correlated with obesity and with type 2 diabetes. 
One interesting finding in the paper is that a study found that taking prebiotics, thereby changing the gut microbiota composition, was associated with greater satiety and reduced hunger as well as food consumption in healthy people. There is a potential for prebiotics to control gut-related inflammation for obese people and would improve the gut barrier function so that prebiotics could help blunt the effect obesity has on inflammation and lipid homeostasis. So, nutrition-wise, adding prebiotics to a dietary plan for people with obesity could potentially have positive effects on their inflammation status and reduce hunger thereby help the patients lose weight. 
Clinically, for patients with diabetes and liver diseases as well as obesity, prebiotics could prove to lessen the symptoms/effects that obesity and inflammation help to foster. 
 
]]> 2022-02-15 02:14:21 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2047581731 Seonwook Kim: High fat diet induces brain insulin resistance and cognitive impairment in mice ski224 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2047832627  

The article that I selected for this week is how high-fat diet induces brain insulin resistance and cognitive impairment. It is known that high-fat diet-induced obesity is associated with insulin resistance and other chronic diet related illness, including dementia such as Alzheimer's disease. This study investigated that diet-induced changes in peripheral insulin sensitivity affect brain insulin signaling and cognitive functions. The key finding of this study is that insulin sensitivity might contribute to cognitive impairment. The nutritional design for this study is that one mice group fed high-fat diet that contain 40% energy from fat with liquid sugar (HFS) and the other group fed normal chow diet that contain 12% energy from fat. HFS group significant increase in obesity and insulin resistance. In addition, HFS mice brain exhibited biochemical changes related to increased amyloid beta deposition and neurofibrillary tangle formation and decreased synaptic plasticity. Those are all important for cognitive function. As a clinical implication, avoiding high-fat diet is beneficial to not only obese patients but also cognitive dysfunction patients.

 

Kothari V, Luo Y, Tornabene T, O'Neill AM, Greene MW, Geetha T, Babu JR. High fat diet induces brain insulin resistance and cognitive impairment in mice. Biochim Biophys Acta Mol Basis Dis. 2017 Feb;1863(2):499-508. doi: 10.1016/j.bbadis.2016.10.006. Epub 2016 Oct 19. PMID: 27771511.

]]> 2022-02-15 05:33:38 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2047832627 Rhoda Inimgba: Genetic susceptibility to obesity and diet intakes: associationand interaction analyses in the Malmo¨ Diet and Cancer Study. inimgbamiebi2000 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049029719 Obesity is one of the major health problems that keep increasing globally. This health problem could be as a result of environmental factors, genetic factors or even both. This study is important because it focuses on the gene-environment factors that could potentially cause obesity. The study talks about if genetic susceptibility to obesity has any association with the diet the person takes in and if also the food taken in by the individual changes the genetic susceptibility. The key finding of the study is that the risk alleles associated to obesity and the individual obesity loci may play a role in the regulation of the amount of food intake and energy and some individual loci may also have an interaction with the diet. This finding relates to nutritional sciences as it shows that the amount of food a person takes in that may lead to obesity may have something to do with their genes and they do not have to utterly change their diet but could just try to have a healthy lifestyle. The clinical implications of this study is that it helps physicians encourage their patients to live a healthy lifestyle and prevent their patients from doing some devastating diets when their weight gain could have nothing to do with the food they intake.

Rukh, G., Sonestedt, E., Melander, O., Hedblad, B., Wirfält, E., Ericson, U., & Orho-Melander, M. (2013). Genetic susceptibility to obesity and Diet intakes: Association and interaction analyses in the Malmö Diet and Cancer Study. Genes & Nutrition, 8(6), 535–547. https://doi.org/10.1007/s12263-013-0352-8.]]> 2022-02-15 16:48:14 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049029719 Obesity, BMI, and Health: a Critical Review lrdu229 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049126409 For this weeks paper, I wanted to look further into Body Mass Index (BMI) and its uses within the medical community. From our course work this week, we have seen that even though BMI is the most commonly used practice to determine body fatness, it is not always the most accurate/inclusive option. This review further states this by using a multitude of studies to show how BMI may not always be the best option when determining obesity in individuals. One problem with BMI is that it does not differentiate between lean mass and fat on the body. This means that people who are higher in lean muscle might fall into a higher BMI category, even though they are not overweight. Another problem is that it doesn't asses body fat location, but it has been shown that the placement of body fat can help determine the individual's health outcomes (morbidity, disease, etc.). One interesting finding was from the EPIC observational study, which found that the risk of death (when combining all factors to look at morbidity) was actually lower in the men with a BMI of 26.5-26.8, even though it is in the pre-obese category of the BMI chart.

This relates to nutritional sciences because the BMI scale has been used habitually since the seventies (it was initially created in  the 1800's and was called the Quetelet Index, named after its creator) in determining an individual's risk for obesity and insurance reasons. BMI is calculated by weight (kg)/ height ^2 (m^2). There have been numerous other ways found that help complete the full picture when identifying an individual's body mass and risk for additional diseases. Some examples of these are skin fold thickness, waist-circumference, underwater-weighing, and DEXA (dual-energy x-ray absorptiometry).

A clinical implication from this study is that we shouldn't rely so heavily on BMI to determine whether or not someone is at risk of obesity (and the conditions underlying it). This is because BMI fails to account for so many other  factors of obesity, by simply focusing on a weight versus height ratio. This could be fixed by taking some influence off of BMI, and including other tests beyond the BMI to fully the determine the individual's condition.

Nuttall, F. Q. (2015). Body mass index. Nutrition Today, 50(3), 117–128. https://doi.org/10.1097/nt.0000000000000092 ]]> 2022-02-15 17:28:31 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049126409 Andrea Ballinger: Weight Bias and Quality of Care of Patients with Obesity https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049309085
The modules this week highlighted that typically, alterations in diet and exercise are recommended for obese patients, when in reality, they are two small factors that may impact patients' health. The paper that I chose for this week's topic is a literature review that focuses on the negative impact physician weight bias can have on the clinical care received by obese patients. Perceived weight discrimination is shown to have a great number of consequences on health outcomes. Consequences discussed in the paper include a decreased compliance to provider recommendations, less weight loss, worse mental health outcomes, impaired patient-centered communication, and fewer clinic visits. What I appreciated about this paper is that it did not place blame on the patient and simply offer nutritional strategies, instead, it provided tangible solutions on the account of the provider. One suggestion included reducing focus on body weight when performing health screenings for possible diseases in which obesity is a risk factor. This paper has great clinical implications in that providers could become aware of any biases they may have, and learn how to provide patients with safer spaces to receive clinical care.

Phelan, S M et al. “Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.” Obesity reviews : an official journal of the International Association for the Study of Obesity vol. 16,4 (2015): 319-26. doi:10.1111/obr.12266]]> 2022-02-15 18:50:15 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049309085 Sidney Harm: Comparative Effectiveness of Childhood Obesity Interventions in Pediatric Primary Care: A Cluster-Randomized Clinical Trial sidneyharm https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049462551 This weeks topic is obesity, it is well known that the prevalence of obesity has steeply increased throughout the last decade. This randomized cluster study looks at the pediatric population and the effectiveness of different intervention types on pediatric obesity. The population included 549 individuals which were in the age range from 6-12 years old with their body mass index (BMI) within the 95% percentile or above. In the intervention groups they used a computerized clinical decision support which adds to the electronic health records and provides; printable educational handouts, referrals to weight management programs, and more helpful resources for obese individuals. There were two intervention groups and one control, one intervention group consists of clinical decision support as well as the individual/family receiving an intervention of self-guided behavior changes. The second intervention group also had clinical decision support but had individualized family coaching. Not surprisingly, it was found both intervention groups had improvements within the participants BMI compared to the control group. A interesting finding within this study was that the group who received family coaching had less improvement for BMI compared to the other intervention group who got the self-guided behavior changes intervention.1 This connects well with this module since this study focused on interventions that were more lifestyle based instead of ‘fat shaming’ that we witnessed in one of our readings this week about weight stigma.
 
References:
 
1.     Taveras, Marshall, R., Kleinman, K. P., Gillman, M. W., Hacker, K., Horan, C. M., Smith, R. L., Price, S., Sharifi, M., Rifas-Shiman, S. L., & Simon, S. R. (2015). Comparative Effectiveness of Childhood Obesity Interventions in Pediatric Primary Care: A Cluster-Randomized Clinical Trial. JAMA Pediatrics, 169(6), 535–542. https://doi.org/10.1001/jamapediatrics.2015.0182
]]> 2022-02-15 20:06:39 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049462551 Low-Carbohydrate Diet versus Low-Fat Diet for Obesity and Hyperlipidemia https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049474152 Ellen Reusch

For this week's wall, I found this article discussing how a low-carbohydrate diet was retained better by patients and resulted in greater weight loss when compared with a low-fat diet. This study included generally healthy participants that were not using any prescription medication or weight loss / diet pills. Participants were randomized to either a low-carbohydrate or a low-fat diet. They were given guidelines for how to prepare their meals and were encouraged to exercise, but not required. Over 24 weeks, the patients who followed a low-carbohydrate diet experienced more weight loss than those in the low-fat diet group. Important to note - the patients who followed a low-carbohydrate diet reported more adverse events related to the diet than the patients that followed a low-fat diet. However, only a small percentage of patients dropped out of the study due to intolerable adverse events. I think this study is important because a high percentage of our population is trying to lose weight at any given time. There are so many "fad diets" that gain popularity and may or may not actually be good for patients to follow in the long term or even in the short term. I think a lot of patients who want to lose weight immediately think they need to cut out all sources of fat and all carbohydrates altogether, which is not a healthy situation at all and could actually do more harm than good. This study highlights how important it is to understand what is happening to your body when you cut out certain food groups. It's important for patients to understand that losing weight is not always reliant on simply decreasing your caloric intake, but sometimes on balancing your caloric intake between all the food groups. This article couple be helpful for some patients who may be struggling to lose weight by following a low-fat diet - perhaps a low-carbohydrate diet would suit them better or help them reach their goals quicker. 

Yancy, et al. (2004) Low-Carbohydrate Diet versus Low-Fat Diet for Obesity and Hyperlipidemia. ACPJournals. https://www.acpjournals.org/doi/pdf/10.7326/0003-4819-140-10-200405180-00006 ]]> 2022-02-15 20:12:30 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049474152 Perceived Weight Discrimination and C-reactive Protein tonyeinimgba99 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049631398 Tamunoerenomie Inimgba-Olunwa

The purpose of the article was to figure out if there was an association between weight discrimination and any physiological markers of health. The authors focused on the interaction between perceived weight discrimination and C-reactive protein (CRP). The CRP is a systemic inflammation marker, which plays a major role as a predictor of cardiovascular disease and diabetes. CRP has also been shown in previous studies to be associated with depression and other forms of perceived discrimination. A key finding in the study was that weight discrimination is associated with an increase in circulating CRP, and this association is moderated by BMI. This relates to nutritional sciences because the health consequences that come along with obesity may never be overcome if better behavioral coping mechanisms associated with perceived weight discrimination are not discussed, as this would only worsen physical health outcomes. Previous articles also discussed that perceiving weight discrimination is definitely associated with risk of becoming and remaining obese over four years. This is because the behavioral ways of coping with weight discrimination has been shown to be associated with higher inflammation. The clinical implications of the study was to identify the link between weight discrimination and physiological mechanisms, and eventually the impact that has on physical health.
Sutin, Stephan, Y., Luchetti, M., & Terracciano, A. (2014). Perceived weight discrimination and C‐reactive protein. Obesity (Silver Spring, Md.), 22(9), 1959–1961. https://doi.org/10.1002/oby.20789
]]> 2022-02-15 22:03:27 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049631398 Mitchell Watts: Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets MitchellWatts https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049767487 This review compared various types of popular diets on their effects on weight loss. The basics for a diet to be effective in weight loss include reducing excessive energy intake, enhancing diet quality, and increasing energy expenditure. This review compared diets based on the manipulation of macronutrient content (low fat, high protein, low carb, ketogenic, etc), diets based on the restriction of specific foods or food groups (gluten free, paleo, vegetarian/vegan, Mediterranean), and diets based on the manipulation of timing (fasting).
 
What was found is that in the short term, diets based on high protein/low-carb and fasting diets were most effective at weight loss, implying that this could be beneficial to jump start weight loss. However, there are potential adverse metabolic effects of these diets, such as with long term adherence to a ketogenic diet. However, in the long term, there were no major differences in the amount of weight loss between diets; therefore, the long-term focus should be on diet quality. The Mediterranean diet for instance focuses on intake of high-quality nutritious foods, and it is easier to adhere to than the more restrictive diets.
 
Overall, the clinical implication of this review is that any one diet could work for someone aiming to lose weight, with potential options for short term weight loss and long-term maintenance. The one important thing to note is that a higher adherence, regardless of diet type, is the determining factor in predicting successful weight loss. Therefore, the focus should be on finding strategies to improve adherence to diets to improve success with weight loss dietary therapies.
 
Freire R. (2020). Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition (Burbank, Los Angeles County, Calif.), 69, 110549. https://doi.org/10.1016/j.nut.2019.07.001
]]> 2022-02-16 00:16:35 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049767487 Obesity and Nutrition in Acute Respiratory Distress Syndrome https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049842634 For this module I decided to look into an article that covered obesity, nutrition and how those two related to respiratory distress syndrome. More specifically so, this relationship was studied in critically ill patients. I found this study to be important because it really shed some light on some important points such as greater body mass index (BMI) is associated with increased length of mechanical ventilation, intensive care and hospital stay. Also the fact that enteral nutrition (tube feeding) should be used in the vast majority of acute respiratory distress syndrome patients, and the role for parenteral nutrition is extremely limited. One key finding to this study that I found to be very interesting was the fact that critically ill patients who are obese are found to be at greater risk to develop acute respiratory distress syndrome but somehow are also found to have greater odds of survival while in the hospital. I believe the clinical implications of this study are how to treat a patient that is obese versus a patient who is not that is suffering from acute respiratory distress syndrome. This article touched base on the amount of protein that should be delivered, enteric feeding versus parenteral feeding, full calorie feedings and the differences in treatment between patients and their BMI.


  Stapleton, Renee D., and Benjamin T. Suratt. “Obesity and Nutrition in Acute Respiratory Distress Syndrome.” Clinics in chest medicine 35.4 (2014): 655–671. Web.

]]> 2022-02-16 01:14:38 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049842634 Obesity and Cancer smayer2247 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049845133 I chose this paper because it bridges obesity and cancer, using inflammation. A BMI of 30 or greater is how obesity is defined and over 35% of American adults find themselves in that category. Obesity has been a growing area of concern for America for some time now and it is estimated that 20% of adult deaths in the US between 1986 and 2006 were due to obesity. When someone is eating nutrients in excess, they are localized to metabolic tissues and triggers inflammation. These inflammatory sites trigger the innate immune system to bring in macrophages and neutrophils. In an inflammatory environment, immune cells are polar and can be triggered to change their function or secretions. This changes to a tumor promoting environment and this study directly links obesity to increased incidence of breast cancer. 
 
            This study shows why nutritional sciences is a very important course and more people should take it. Knowing how to better manage your lifestyle and food choices can save your life. Clinical implications could mean doing more anti-inflammatory immunotherapy in obese populations on a large scale to help prevent the increased risk of cancer. Immunotherapy and control of the symptoms are the target for those people who may not be able to exercise or have the luxury of a balanced diet due to budget or food availability.
 
 Kolb, R., Sutterwala, F. S., & Zhang, W. (2016). Obesity and cancer: inflammation bridges the two. Current opinion in pharmacology, 29, 77–89. https://doi.org/10.1016/j.coph.2016.07.005
]]> 2022-02-16 01:16:05 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049845133 Kate Mashburn: LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth katecmashburn https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049868121 This article really interested me because it ties what we are learning in class with a part of my research project involving government programs influencing healthcare. In the study, they showed how an interactive gardening and cooking program promotes better eating habits in children which, in turn, lowers the chances of obesity. This is important because rather that lecturing children on making better food choices, the study showed kids HOW to make those choices. They made it a learning experience. The study mainly focused on a lower-income latino group in Los Angeles. The study concluded that this program was a success. Participants lowered their overall body mass and waist circumference. However, it called for a longer study that broadened its participants and location so that more people can learn how to make better nutritional choices. This is definitely warranted because as more of these studies show successful results, it would be more likely to obtain government funding for a permanent program being established in these communities.

Gatto NM, Martinez LC, Spruijt-Metz D, Davis JN. LA sprouts randomized controlled nutrition, cooking and gardening programme reduces obesity and metabolic risk in Hispanic/Latino youth. Pediatr Obes. 2017 Feb;12(1):28-37. doi: 10.1111/ijpo.12102. Epub 2016 Feb 22. PMID: 26909882; PMCID: PMC5362120.]]> 2022-02-16 01:31:24 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049868121 Fat as a Risk Factor for OverconsumptionSatiation, Satiety, and Patterns of Eating Cassie_Craig https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049888996 This study was important because it assessed the risk of consuming foods with high fat content. The term passive overconsumption is used to explain how foods with a high fat content a prominent impact on appetite don’t have, making it easy for someone to overeat without realizing. This study found that patients with a higher fat intake in their diet had a higher rate of obesity than patients with a lower fat intake in their diet. This is important in nutritional sciences because people need to be aware of how much fat they are consuming in their diet. This is important in a clinical setting because it can be used preventatively, as well as in response to obesity. All patients should focus on trying to eat low-fat foods to avoid passive overconsumption. 

Blundell JE, MacDiarmid JI. Fat as a risk factor for overconsumption: satiation, satiety, and patterns of eating. J Am Diet Assoc. 1997 Jul;97(7 Suppl):S63-9. doi: 10.1016/s0002-8223(97)00733-5. PMID: 9216571.]]> 2022-02-16 01:46:41 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049888996 Joe Devine: Obesity and insulin resistance https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049938002 The article I chose to write about his week is about insulin resistance and its affect on obesity. There is a complicated relationship between insulin resistance and obesity and the study suggests that insulin has a regulatory role on the biology of adipocyte tissue. While the insulin signaling cascade has many steps within these tissues an important step is their abliity to stimulate glucose transport and lipogenesis. However, the study points out that excessive adipose tissue and low adipose tissue can cause insulin resistance. This is a confounding example that highlights the ability of adipocytes to act as endocrine cells because of their ability to affect cells through secretions. There is a lot of moving parts to to insulin resistance and its correlation to obesity which prompts future research that will prove to be difficult.



Kahn, B. B., & Flier, J. S. (2000). Obesity and insulin resistance. The Journal of clinical investigation, 106(4), 473–481. https://doi.org/10.1172/JCI10842]]> 2022-02-16 02:23:52 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2049938002 Obesity Stigma: Important Considerations for Public Health jaidag99 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2050019523 This study is important because as a society it's important to leave the stigma of obesity behind. The study addresses stigma and a way to motivate individuals who may be at an unhealthy weight or have bad habits in a proper way. A key finding I found very useful is how shame and prejudice influenced by stigma is not a healthy way to encourage weight loss. Instead, it does the complete opposite of being a type of social control to encourage an even worse behavior. In order for public health to improve, the stigma with weight loss must disappear. Stigmatizing obesity encourages a decline in mental and emotional health, which also eventually effects progressive weight loss. Physicians also knowing the research and trends regarding weight stigma and how often those individuals don't get regular cancer checks and or other healthcare screenings, will for sure help patient physician relationships. This article also has so much more great information worth seeking for further understanding.


Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American journal of public health, 100(6), 1019–1028. https://doi.org/10.2105/AJPH.2009.159491



]]> 2022-02-16 03:28:07 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2050019523 Trends in Cigarette Smoking and Obesity in Appalachian Kentucky - Dierra Doaks https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2050079790 The article I chose to write about this week is about the rates of obesity and cigarette smoking in Appalachian Kentucky. The purpose of the article was to determine the factors that are associated with smoking and obesity in health disparity regions like Appalachian Kentucky.  The method used for the study was examining data from phone surveys that ranged from 2001 to 2010.  The authors of this article explain that obesity rates in Appalachian adults are much higher than in non-Appalachian Kentucky or in the United States overall. All grades of obesity are associated with elevated rates or mortality which could help explain the fact that life expectancy in the Appalachian population is much lower than the general U.S population (about 4 and 3 years less for men and women). In 2015,  Kentucky was classified as one of the twelve states in the United States with an obesity prevalence rate greater than 30.9%. More than one-third of the Kentucky’s Appalachian population was considered obese in 2015. This article has a lot of interesting information needed to address the problems in these areas. I would be interested to see how these numbers have changed since this article was published. 


Schoenberg, Nancy E et al. “Trends in Cigarette Smoking and Obesity in Appalachian Kentucky.” Southern medical journal (Birmingham, Ala.) 108.3 (2015): 170–177. Web.

]]> 2022-02-16 04:22:18 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2050079790 Ultra-Processed Food and The Risk Of Overweight And Obesity: A Systematic Review And Meta-Analysis Of Observational Studies clwi230 https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2050094327 This systematic review and meta-analysis was conducted to evaluate the relationship of consuming ultra-processed foods with obesity and overweight adults. One key finding of the meta analysis illustrated that there was a 26 percent increased odds of obesity with the consumption of ultra processed foods. Meta analysis are conducted to establish statistical significance. The authors were able to statistically support the connection between obesity and ultra processed foods. Ultra-processed foods are formulated to be easy to consume due to their manufacturing. They are quick meals and often instant and low in nutritional value. Ultra-processed foods have become widely accessible as the global food market continues to change.  This meta-analysis can support nutritional guidelines created for those with obesity because of the statistically significance identified with obesity and its prevalence with quality of the food consumed. Tracking food consumption and making conscious change to the quality of food consumed can serve as preventative treatment for those who are at a higher risk of obesity.  

 

Askari, M., Heshmati, J., Shahinfar, H., Tripathi, N., & Daneshzad, E. (2020). Ultra-processed food and the risk of overweight and obesity: a systematic review and meta-analysis of observational studies. International journal of obesity, 44(10), 2080-2091.

-Clarisa Williams

]]> 2022-02-16 04:35:49 UTC https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2050094327 Julie Rees tccjrr https://padlet.com/sarapolice/gv78w878l5hfb2iy/wish/2057777318 This article goes back to previous discussions regarding gut microbiome and intestinal permeability in regard to inflammation.  Not only does the composition of the gut microbiome affect conditions from the previous module such as Crohn’s disease, it appears to play a role in inflammation present in persons with obesity.  This study looked at the gut bacteria in obese and non-obese persons and found a distinct difference in the amount of biodiversity with the obese group being much less diverse than the non-obese group.  As I discussed in a previous paper, diet plays a major role in the composition of an individual’s gut microbiome.  This study found that the subjects with higher BMI had a reduced percentage of anti-inflammatory bacteria and a higher percentage of pro-inflammatory bacteria compared to the other group.  This suggests that not only does obesity contribute to chronic inflammation from adipose tissue but also from the gut microbiome.


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